Heroin Detox Treatments

Posts Tagged ‘narcotics’

Medical Detoxification is a process in which individuals are systematically and safely withdrawn from addicting drugs, usually under the care of a physician. Drinking alcohol or using drugs causes physical dependence over time in some people. Stopping the use of alcohol or drugs results in physical withdrawal from these substances in people with a physical dependence. The detoxification process is designed both to treat the acute physiological effects of stopping drug use and to remove residual toxins in the body left as a result of using the chemicals found in drugs and/or alcohol.

Medical Detoxification: In order to withdraw from certain addictive substances safely, it may be preferable and in some cases necessary to undergo medically supervised detoxification in a hospital or residential treatment center that has a detoxification unit. This would be advisable for patients that have been using an addictive substance heavily for a longer period of time and are more likely to have more severe withdrawal symptoms, or those with other significant health problems. Inpatient detoxification allows the patient to be closely monitored throughout the process and given appropriate medication to prevent severe withdrawal symptoms. It commonly involves the gradual administration of decreasing doses (tapering) of an agent that is related to the original drug of abuse that is now substituted to prevent withdrawal.

Rapid Detoxification: In this procedure drug withdrawal occurs while patients are asleep under general anesthesia. The patient is given intravenous injections of medications called opiate blockers which stop the action of narcotics and opiate drugs as well as injections of other medications that reduce the symptoms of withdrawal such as muscle relaxants or anti-nausea medications. This process results in rapid withdrawal from the physical effects of addiction. Through the use of opiate blockers such as naltrexone, naloxone, and nalmephine, physical detoxification is achieved within 4 to 8 hours. Rapid detox takes place in an intensive care unit of a hospital. Patients are usually discharged within 48 hours following recovery from anesthesia and assessment of their physical status.

Rapid detoxification helps reduce the distress of opiate withdrawal for people who are chemically dependent on narcotics such as heroin, Vicodin, Percocet, Demerol, Dilaudid, Darvocet, OxyContin, opium, morphine, codeine, oxycodone, hydrocodone, prescription painkillers, and all narcotic type drugs. It shortens the detoxification period and spares patients the pain and physical discomforts of withdrawal. It may be of great benefit to patients who suffer from severe withdrawal symptoms and who have failed repeatedly to complete conventional withdrawal programs . However, there are significant costs as well as risks associated with the use of general anesthesia. It is imperative that the procedure be performed by medical professionals who are highly trained in these procedures in a medical setting that is fully equipped to deal with any complications that may arise.

Stepped Rapid Detoxification: This alternative to rapid detoxification provides small doses of Narcan (Naloxone) subcutaneously and naltrexone orally every hour or so, together with reduced withdrawal management medications , mostly orally, as necessary. This approach using the slower oral and subcutaneous routes rid the body of the opiate more slowly than intravenous Rapid Detoxification . In addition the pacing can be controlled and responsive to any withdrawal symptoms that develop in the patient by having them quickly suck on Buprenorphine tablets under the tongue. There is less need for withdrawal management medications. The patient is alert and directly communicating with medical staff until the situation has been resolved. It is possible to be detoxified and stabilized on Naltrexone Maintenance Therapy with 2 to 4 small manageable bites. If someone tries to use any kind of opiate while they are on Naltrexone, they feel no effect because all of the receptors are completely blocked.

Ultra Rapid Detoxification: This procedure involves putting patients under general anesthesia and giving them a drug called Naltrexone which blocks all of their endorphin receptors. This accelerates the withdrawal process, pushing them into 100% detoxification within a 5-30 minute period. Although this is an extremely painful process it is tolerable under anesthesia. As with rapid detoxification, it is very costly and has significant medical risk.

Outpatient Detoxification
Outpatient medical detoxification is usually safe and effective for people who are more likely to have mild to moderate withdrawal symptoms. For instance, primary care-based opiate detoxification can be accomplished with a variety of medications such as buprenorphine-naloxone (BUP/NX) or clonidine alone or combined with naltrexone. Buprenex, newly approved by the FDA, can now be administered on an outpatient basis by physicians who receive a required eight-hour training. Using Buprenex, the detoxification can take between 7-14 days.

Coming back from the cycle of addiction is a long and tough road. Not only does it take a lot of courage and determination, but it’s physically and mentally taxing as well. When you’ve finished your treatment and are in recovery, you really need the love, support and encouragement of your loved ones to help you maintain your sobriety. So what happens if your loved ones cannot forgive your addiction? What if there’s so much weight in your baggage that they can’t look beyond the past?

Don’t worry. You can get past this. Here are some things to keep in mind.

First Things First

It’s important to recognize yourself first for the incredible achievement you’ve attained. At this stage of the game, you’ve completed your treatment – however personally challenging that may have been – and are now in recovery. This accomplishment alone is reason to celebrate. Sure, it would be great if your loved ones stood up and gave you credit for this, but it doesn’t detract from the fact that you did it. So, before you think about anything else, give yourself high marks for reaching this milestone.

Count Your Blessings

Now, while you are still giving yourself kudos for reaching the recovery stage, count your blessings for all the positive things that you have in your life. Loved ones notwithstanding, you do have them. Here are some that should rate high on your list. You now have a healthier physical condition, due to the fact that your body is no longer full of the harmful substances you previously ingested, or the addictive lifestyle you once maintained. You’ve made a lot of progress in understanding the roots and underlying causes for your addiction, learned how to identify triggers and how to avoid giving in to them. You worked hard on your self-esteem and self-confidence, learning that you have contributions that you can make to society. Even if you never felt that you made much of a difference before, you now know that each person can impact the lives of many around them, and that you have a tremendous opportunity to not only benefit your own future, but those of others as well.

These are all terrific blessings – and they don’t cost you a penny. While you’re at it, you can probably rattle off a few more. Include the fact that you now sleep better, are less depressed and anxious, look forward to each day rather than dreading what it will bring, and others.

How Bad is the Relationship?

Still, you need the love and support of those closest to you. Whether this is your spouse or partner, children, siblings or parents, the relationships mean a lot and are definitely worth preserving or repairing. Before you attempt to make any amends, however, you should first look at how bad the situation is with your loved ones. What do you see is the biggest obstacle to being whole again in their eyes? In other words, what will it take for them to forgive you – if you know? Maybe you think it is one thing, when, in fact, it may be something else altogether. Don’t just assume. Sit down and really try to figure it out.

Let’s say you’re the husband of a working wife who’s been struggling to keep the family together while you were in treatment. If there are children involved, magnify that struggle by increments depending on what shape (financially, emotionally, socially, etc.) the family was in prior to your entering treatment. Chances are, the inability of your loved ones to forgive you have a lot to do with heavy-duty emotional turmoil. Your spouse, for example, shouldered the burdens while you were away. She had to make many decisions on her own, not being able to get your input, or the situation demanded immediate attention. For a wife used to sharing decisions with her husband, this can take a tremendous toll.

Perhaps she had to scrimp to help pay for your treatment, since your insurance coverage either only covered part of it or you didn’t have any coverage. Having to sacrifice comforts the family has come to rely on or even pare necessities to the bone will build up resentment in the strongest and most caring person. Add that to the list of perceived grievances.

Being the sole parent also meant she shouldered dual roles in your absence. It’s tough to show love, dole out discipline when necessary, keep up appearances and try to ensure the children still have fun when you’ve got so much riding on the situation. She may have begun to wonder if the family would be better off without you. This thought, which is certainly understandable, would likely be instantly quashed as out of the question or a sign of betrayal (although it could still lurk beneath the surface). As you know from your own treatment, when you bury your emotions, they come back to haunt you or, at the very least, make growth more difficult.

While the above is just one example, the point is that you should make a list of the things that you believe stand in the way of your loved one forgiving you for your addiction. Once you have the list, you can go on to the next step.

Figure Out What to Do About It

Work down your list and try to come up with solutions to the problems. Again, this is something you do on your own even before having any conversation with your loved ones. Taking financial concerns into consideration, perhaps you can address how and when you will be able to alleviate this concern. Can you go back to your previous job? What are your employment prospects?
Did you get training in a new vocation or skill while you were in treatment? How willing are you to take any kind of job to
immediately start contributing to the family’s well being?

Recognize that you may have to start from scratch. You may have burned your job bridge behind you if you were fired for your addictive behavior. Or, your prospects upon your return may be limited for some time to come. In either case, start where you are and work your way back up. It’s really the only option you have, since you do have obligations and need to resume your role within society.

If you need training, look into how you can get it. Take any job and go to school at night, or learn a new trade or skill in an apprenticeship. Another advantage to tackling the financial concerns that may stand in the way of your loved ones’ forgiveness is that you will be doing something positive for yourself as well. Now could be the opportunity to ditch the old job you found boring or distasteful, or not reflective of your true talents or desires. Figure out what it will take for you to get where you really want to be – and then draft a plan to make it happen.

No, this goal won’t be realized overnight. It may take years for you to complete your degree, build up your own business, or become profitable, for example, but it is a positive first step toward eventually achieving the goal.

Speaking of time, it may be that you’ll need to prove yourself to your loved ones by being on your own for a while. It may be too painful for them to have you home on a full-time basis for now. You will need to accept that and really work at making the kinds of changes that can turn that around.

As for the emotional barrier that undoubtedly puts a strain on your relationship moving forward, this, too, requires time. Your loved ones may miss the financial security and feeling of self worth that came from having things in control – prior to your problems with addiction. A drastic drop in self confidence and self worth inevitably follows in the path of addiction, affecting everyone in the family. In fact, emotional turmoil is difficult for loved ones to overcome without some form of family treatment or counseling. They often are not able to see past barriers without professional help. Fortunately, such counseling is relatively easy to access – either as part of your aftercare treatment program, or through community services or self-help groups such as Al-Anon/Alateen, Nar-Anon, and others.

Remain Positive and Upbeat About the Future

Although it seems hard to look at a future without your loved ones in it, for now just keep as upbeat and positive as you can. Reach out to your support network of 12-step members and step up your meeting attendance. This is especially important at time in your life when your family environment may be severely constrained or restricted.

Your 12-step allies also include your sponsor. Don’t be afraid to ask for help from your sponsor, since he or she is ready, willing and able to give you the kind of encouragement and support you need, 24/7. You already have a pretty good familiarity with the 12-step process through contacts during your treatment program – if you went through a formal treatment program. If not, you do have a ready-made support network available to you through 12-step fellowships. There are 12-step groups for every kind of addiction. They are free to attend and have no memberships or dues. All they ask is for voluntary donations if you are able.
While the philosophies are similar and all are based on the 12-step principles, each has its own original focus and personality, if you will.

Here are some of the 12-step groups:

• Alcoholics Anonymous
• Cocaine Anonymous
• Crystal Meth Anonymous
• Debtors Anonymous
• Gamblers Anonymous
• Marijuana Anonymous
• Narcotics Anonymous
• Sexaholics Anonymous
• Sex and Love Addicts Anonymous
• Sex Addicts Anonymous
• Sexual Compulsives Anonymous
• Workaholics Anonymous

Besides in-person meetings, 12-step groups often offer online and phone meetings, blogs, and chats. Each group has its own website which provides access to articles, news, books, CDs, DVDs, and other resources, as well as helpful links for additional help. When you’re feeling down or lonely in the middle of the night, go online and check out some literature that may help – or get in touch with your sponsor or other 12-step group member with whom you have established a connection.

Make a Plan – and Stick To It

Besides continuing counseling, keeping an upbeat attitude and seeking the support and encouragement from your 12-step groups, what else can you do? The best advice is to make a plan, and stick to it. What do we mean by that? What kind of a plan are we talking about? It doesn’t matter what your plan is, or how simple or detailed. The point is that you will be doing yourself a great service by sitting down and designing a plan for your future.

Note the emphasis on your future. Here we are talking about what it is that you want for yourself one year, 5 to 10 years, or longer down the road. Make a list of your short-term (1 to 2 years), intermediate term (3 to 5 years), and long-term (5 to 10 years and beyond) goals. In the next column, jot down what you may need to do in order to reach the particular goal. This may include going to school, getting training, learning a new language, becoming proficient at a sport, joining a recreational or travel group, or something else. In the next column, write down everything you can think of in the way of resources available to help you get started. Include websites, organizations, advice or recommendations from friends, scholarships, grants, community, state or federal programs, etc.

Once you have your list, get started on the short-term goals, things you can tackle right away. Keep in mind that you should strive to make some progress each day or week toward your intermediate and long-term goals as well. This can take the form of gathering information, checking out websites, filling out applications, taking a class, and so on. Remember that your list of goals is only a guideline. Nothing is written in stone. Keep it flexible and always consider it a work in progress. Once you achieve a goal, take time to acknowledge your achievement. Give yourself the credit you deserve.

While you are pursuing your goals, and especially when you reach milestones in your sobriety (first year of sobriety, for example), take a moment to reflect how much differently you feel now than at the beginning of your recovery. Each small step you take toward the future means that much more progress that you have made. Your overall outlook will change as well. You will look forward to each day as a new opportunity to make a difference.

During this time, if not before, you may have been able to repair your relationship with your loved ones. If they have not forgiven you, they may have at least accepted your sincere expression of wanting to make amends. You will find that you will be able to move on. To do this most effectively, you need to be able to forgive yourself. Forgiveness from others, including your loved ones, has more of a chance.

There is an old expression, When one door closes, another opens. This is true in recovery from addiction as well. Open your heart to be able to receive love, as well as give it.

Source: www.drugaddictiontreatment.com

Buprenorphine was initially introduced on the market in the 1980s as an analgesic. Now, its primary use is for the treatment of opioid addiction.

One dose of buprenorphine remains active in the human body for as long as 48 hours, which provides a longer duration than morphine. This is one of the qualities that make this drug ideal for helping opioid addicts to break free of their addiction. Since the drug remains in the body for 48 hours, it also ensures that the withdrawal symptoms that people experience are significantly decreased.

Buprenorphine requires sublingual (under the tongue) administration on a frequent basis. Drug administration should always be supervised by a substance abuse treatment professional, and doses must be strictly monitored. Federal regulations require this in order for treatment centers and medical facilities to be able to administer the drug at all.

There are some side effects that can occur along with the use of buprenorphine. They range from moderate to severe, and it should be pointed out that this drug can, in some cases, produce fatal side effects. The most commonly occurring side effects include the following:

• Headache

• Drowsiness

• Dizziness

• Vomiting

• Decreased libido

• Constipation

• Respiratory depression

Respiratory depression is the side effect that presents the most serious problems with the use of buprenorphine, as it can be fatal in some people. Unfortunately, there is no way to correct or treat this problem should it develop.

While undergoing buprenorphine treatment, all patients are regularly monitored to see how their livers are functioning, as some adverse effects can be caused by using this drug.

Even though buprenorphine is used to treat people with opioid addictions, the possibility does exist for an addiction to the buprenorphine itself to develop. The types of dependencies that can develop include both physical and psychological. People who are considering undergoing treatment with this drug should be aware, however, that instances of people becoming addicted to buprenorphine are quite rare.

Often times, one of the primary questions that people have is whether they should choose buprenorphine or methadone as a treatment option. Both of these drugs are routinely used for short-term and long-term treatment of opioid addiction. Dosing requirements may be a bit better with buprenorphine simply because of the drug’s ability to remain in the body for 48 hours, thereby offering longer-term effects. With buprenorphine, patients typically only have to receive a dose every other day, while methadone requires daily dosing.

Buprenorphine also has an advantage regarding the total amount of treatment time that is required to successfully complete a detoxification program. With buprenorphine, treatments generally last for a few months, while with methadone indefinite or sometimes lifelong treatment is necessary.

It is very important that buprenorphine be administered in an inpatient treatment facility, particularly one that specializes in substance abuse treatment. Inpatient treatment programs not only offer patients detox programs, they also offer treatment or rehabilitation programs that are designed to help people learn healthier ways of living. Some of these treatment programs include counseling, diet and exercise, massage, acupuncture, and group therapy.

The purpose in these additional treatments is to give patients a better chance of maintaining success by giving them the tools they need to lead lives that are free of substance abuse. If patients learn how to be healthy and happy (physically and emotionally) then they will be far less likely to have a relapse.

A large majority of 365 Internet sites that advertise or sell controlled medications by mail are offering to supply the drugs without a proper prescription, according to a new study. The online trade is stoking the rising abuse of addictive and dangerous prescription drugs, the authors and federal officials say.

Drugs offered online include generic versions of opiates like OxyContin, methadone and Vicodin, which are legitimately prescribed as painkillers; benzodiazepines like Xanax and Valium, which are prescribed for anxiety; and stimulants like Ritalin.

Federal and state efforts to crack down on Internet sales appear to have reduced the number of sites offering such drugs, from 581 last year, said Joseph A. Califano Jr., director of the National Center on Addiction and Substance Abuse at Columbia University.

“Nevertheless, anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse,” Mr. Califano said. The center is issuing the study, the latest of five annual surveys, on Wednesday.

The Drug Enforcement Administration found that 85 percent of all Internet prescription sales involved controlled drugs, compared with just 11 percent of those filled through regular pharmacies, suggesting that online sales often are destined for misuse.

“Abuse of prescription drugs has exploded among college students, and we think that one way they get these drugs is over the Internet,” Mr. Califano said. The use of prescription opioids and anxiety drugs, especially in combination, accounts for a growing share of deadly overdoses nationwide.

“The Internet made it easy for the drug dealers to sneak into your living room,” said Francine Haight of La Mesa, Calif, whose son Ryan died in 2001 at the age of 18 from an overdose of hydrocodone, generic Vicodin, which he had secretly ordered online with a debit card. An A-student and varsity tennis player, he had claimed in an online questionnaire to be a 25-year-old with back pain, got his prescription and was mailed the drug. Ms. Haight, a registered nurse, has since fought against online sales.

Federal law bars dispensing dangerous medications without a prescription from a doctor who has a bona fide relationship with the patient. But officials have had a hard time catching up to rogue Internet pharmacies that sometimes ship the drugs from foreign countries in disguised packages.

For the last several years, the Drug Enforcement Administration and others have worked to halt the illegal trade and prosecute involved doctors and suppliers, with limited success.

“One of the main problems is that the sites can literally open up for a week, close and open up under a different name,” said Michael Sanders, a spokesman for the Drug Enforcement Administration.

In a more recent practice, the new study found, some sites sell written prescriptions that can then be used at local pharmacies.

Using popular search engines like Google, Yahoo and MSN, the Columbia researchers found 365 sites offering controlled drugs by mail. Of these, 206 were advertising sites, directing consumers to a seller. Of the 159 sites that directly sold controlled drugs, 135, or 85 percent, did not require a prescription or provided them on the basis of online questionnaires.

In an effort to make their surveys consistent, in each of the last five years the researchers have spent the same amount of time searching, 210 hours, for the same list of drugs. The number of sites rose to 581 in 2007, then fell to 365 this year. The study will be available online on Wednesday at www.casacolumbia.org.

In April, the Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act, which would require certification of online pharmacies and that doctors see patients before prescribing controlled drugs. The bill is now in committee in the House.

At least eight states have passed laws barring electronic prescribing or sales without a legitimate prescription. Minnesota passed a law in 2007 requiring doctor-patient consultations but found that “the Web sites went around us, doing 30-second consultations on the phone,” said Dan Pearson of St. Cloud, Minn., whose son Justin died of drug poisoning in 2006, aged 24, after obtaining large quantities of hydrocodone and Xanax from 17 online pharmacies. The law was strengthened this year to require face-to-face consultations.

“Anyone can have these drugs at their door within 48 hours,” usually using a credit or debit card to pay for an online prescription and then a money order to pay for express delivery, C.O.D., Mr. Pearson said.

Federal drug authorities have begun working with credit card companies and banks to try to prevent such transactions, while major Internet search engines have used a verification program called Pharmacy Checker to confirm that advertisers are legitimate. But the system appears to be full of holes, critics say.

Mr. Califano sent letters this week to senior officials of Google, Yahoo and MSN asserting that they were “profiting from advertisements for illegal sales of controlled prescription drugs online,” and calling for stronger action.

Diana Adair, a spokeswoman for Google, said the company took the problem seriously and in addition to using Pharmacy Checker, had consulted with federal agencies on ways to stem the trade. Kelley Benender, a spokeswoman for Yahoo, said the company was “working to identify the illegal sites and will take appropriate action.”

A spokesman from MSN said the company had no comment.

By ERIK ECKHOLM from The New York Times

F.D.A. to Place New Limits on Prescriptions of Narcotics

WASHINGTON — Many doctors may lose their ability to prescribe 24 popular narcotics as part of a new effort to reduce the deaths and injuries that result from these medicines’ inappropriate use, federal drug officials announced Monday.